Provider Demographics
NPI:1962028886
Name:TUNG, YUANZEN (MFT)
Entity type:Individual
Prefix:MS
First Name:YUANZEN
Middle Name:
Last Name:TUNG
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ZEN
Other - Middle Name:
Other - Last Name:TUNG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:497 S EL MOLINO AVE UNIT 207
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3488
Mailing Address - Country:US
Mailing Address - Phone:626-429-2998
Mailing Address - Fax:
Practice Address - Street 1:960 E GREEN ST STE 114
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-429-2998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA115119106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist